Epstein Pearls in Infants - Surya Dental Care
                     Epstein Pearls in Infan
ts
AGENDA
• What Are Epstein Pearls?
• Causes of Epstein Pearls
• Symptoms and Appearance
• Risk Factors
• Differentiating Epstein Pearls from Other Conditions
• Diagnosis and Treatment
• Home Care and When to See a Doctor
• Key Takeaways for Parents
What Are Epstein Pearls?
Definition Appearance Nature
Epstein pearls are small cysts They are tiny, white or These cysts are harmless, filled 
that appear inside a baby's yellowish, dome-shaped bumps with keratin protein, and 
mouth, commonly on the gum measuring 1–3 mm in diameter, naturally resolve on their own 
line or roof of the mouth, often mistaken for emerging without causing pain or 
especially in newborns. teeth by parents. requiring treatment.
Causes of Epstein Pearls
• Epstein pearls develop during fetal mouth formation while the baby is still in the womb.
• During palate fusion, some skin cells (epithelial cells) become trapped in the mouth’s 
developing tissues.
• These trapped cells fill with keratin protein, forming tiny cysts called Epstein pearls.
• This process is natural and does not indicate any infection or injury.
• Epstein pearls are benign and do not represent any underlying disease or abnormality.
Symptoms and Appearance
Size Epstein pearls are small cysts, usually ranging from 1 to 3 millimeters in 
diameter, making them barely noticeable at first glance.
Color and Shape These cysts appear white or yellowish and have a smooth, dome-shaped 
surface, resembling tiny pearls inside the mouth.
Location They are commonly found along the midline of the roof of the mouth (palate) or 
on the gums, particularly near the front teeth area.
Symptoms Generally painless and harmless, Epstein pearls do not cause any feeding 
difficulties or discomfort to the infant.
Risk Factors
Delivery Method Epstein pearls occur more frequently in newborns delivered vaginally, 
possibly due to pressure during birth contributing to their formation.
Birth Term Full-term infants are more likely to have Epstein pearls, whereas 
premature babies tend to have a lower incidence of these cysts.
Maternal Factors Babies born to first-time mothers may show a slightly higher chance of 
developing Epstein pearls compared to those born to mothers with 
previous births.
Non-Contagious and These cysts are not caused by infections or poor hygiene and are not 
Harmless contagious, posing no health risks to the baby.
Differentiating Epstein 
Pearls from Other 
Conditions
Epstein Pearls Natal or Neonatal Teeth Bohn’s Nodules & Oral Thrush
These are small, white or yellow Actual teeth present at birth or Bohn’s nodules are benign keratin 
cysts found on the roof of the erupting shortly after. They are cysts similar to Epstein pearls but 
mouth or gum line in newborns. hard, fixed in the gums, and can found on the sides of the gums. Oral 
They are harmless, painless, and sometimes cause discomfort or thrush is a fungal infection presenting 
as white patches on the tongue or 
caused by trapped keratin. Epstein feeding issues. Unlike Epstein 
cheeks, often causing discomfort and 
pearls do not affect feeding or pearls, these are true teeth, not requiring medical treatment.
cause discomfort. cysts.
Diagnosis and Treatment
Diagnosis of Epstein ● Identified through simple physical examination by a pediatrician or 
Pearls pediatric dentist
● Characteristic white or yellow small cysts along gum line or roof of mouth
● No special tests or investigations needed due to distinct appearance
● Diagnosis often made during routine newborn check-ups
Treatment and Care ● Epstein pearls do not require any medical treatment
● They naturally resolve and disappear within a few weeks after birth
● Avoid poking or squeezing to prevent irritation or infection
● Maintain normal feeding and oral hygiene practices
Home Care and When to See a Doctor
Avoid Poking or Squeezing Maintain Feeding Routine Keep Mouth Clean
Do not poke or squeeze the Epstein Continue breastfeeding or bottle- Gently clean your baby’s mouth to 
pearls to prevent irritation or feeding as usual to ensure your remove milk residue, promoting 
infection in your baby’s delicate baby stays nourished and overall oral hygiene without special 
mouth. comfortable. treatments.
Watch for Changes Consult a Pediatrician
Observe the bumps for any growth, Seek medical advice if bumps 
color change, or signs of discomfort persist beyond a few weeks, cause 
that may indicate a need for feeding issues, or show redness, 
medical evaluation. swelling, or discharge.
Key Takeaways for Parents
Epstein pearls are benign, keratin-filled cysts that commonly 
appear in newborns and typically disappear without any 
treatment within a few weeks. They do not cause pain or feeding 
issues, so parents need not worry if they notice these small white 
or yellow bumps in their baby's mouth. However, if the bumps 
grow, change color, cause discomfort, or persist beyond several 
weeks, consulting a pediatrician is important to rule out other 
conditions. Overall, Epstein pearls are a normal part of infant oral 
development and usually require no intervention.
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